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Amended Report Of Vehicles Used For Delivery Of Beer Or Wine LC MW 136A - Michigan
| Amended Report Of Vehicles Used For Delivery Of Beer Or Wine Form. This is a Michigan form and can be used in General Licensing Liquor Control Commission Statewide . |
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Michigan Department of Labor & Economic Growth LIQUOR CONTROL COMMISSION 7150 Harris Drive, P.O. Box 30005 - Lansing, Michigan 48909-7505 AMENDED REPORT OF VEHICLES USED FOR DELIVERY OF BEER OR WINE LICENSEE NAME AND BUSINESS ADDRESS TYPE OF LICENSE/LICENSE NO. SIGNATURE DATE Licensees are required to file this form when they add or delete previously licensed trucks and when they replace licensed trucks. Failure to complete this form and pay any subsequent fees is a violation of the Liquor Control Code. The licensee is responsible for removing and destroying the decal of any truck before it leaves the licensee's possession. These trucks are recorded in Section C below. The licensee's statement is required in Section D. New decals will be issued for trucks in Section A and B. Section A Added Trucks (Increase number of licensed trucks) - $50 each. Make checks payable to "State of Michigan." (LCC Use Only) Decal Number Assigned Make of Vehicle Style of Body Year or Model Vehicle Identification Number Instructions Section B New Replacements (No change in number of licensed trucks) no charge. These trucks replace those in Section C. (LCC Use Only) Decal Number Assigned Make of Vehicle Style of Body Year or Model Vehicle Identification Number Section C Replaced Trucks (No change in number of licensed trucks) no charge. These trucks were replaced by those in Section B. Decal Number Assigned Make of Vehicle Style of Body Year or Model Vehicle Identification Number Section D I certify that I have destroyed the decal for any truck shown in Section C. Signature Title Date Cashier Validation (Do not write in this space.) LC-MW 136A (Rev. 03/04) AUTHORITY: MCL 436.1525 COMPLETION: Mandatory PENALTY: License Revocation The Department of Labor & Economic Growth will not discriminate against any individual or group because of race, sex, religion, age, national origin, color, marital status, political beliefs or disability. If you need help with reading, writing, hearing, etc., under the Americans with Disabilities Act, you may make your needs known to this agency. American LegalNet, Inc. www.FormsWorkflow.com
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